title: Societal costs of prescription opioid abuse, dependence, and misuse in the United States.
abstract: OBJECTIVE
  The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States.
  
  
  METHODS
  Costs were grouped into three categories: health care, workplace, and criminal justice. Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse. Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries. Other data/information were derived from publicly available survey and other secondary sources.
  
  
  RESULTS
  Total US societal costs of prescription opioid abuse were estimated at $55.7 billion in 2007 (USD in 2009). Workplace costs accounted for $25.6 billion (46%), health care costs accounted for $25.0 billion (45%), and criminal justice costs accounted for $5.1 billion (9%). Workplace costs were driven by lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion). Health care costs consisted primarily of excess medical and prescription costs ($23.7 billion). Criminal justice costs were largely comprised of correctional facility ($2.3 billion) and police costs ($1.5 billion).
  
  
  CONCLUSIONS
  The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.
authors.affiliation: Analysis Group, Inc., Boston, MA, USA. hbirnbaum@analysisgroup.com
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Alan G
authors.initials: AG
authors.lastname: White
authors.forename: Matt
authors.initials: M
authors.lastname: Schiller
authors.forename: Tracy
authors.initials: T
authors.lastname: Waldman
authors.forename: Jody M
authors.initials: JM
authors.lastname: Cleveland
authors.forename: Carl L
authors.initials: CL
authors.lastname: Roland
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000191:economics*; D002648:Child; D017281:Cost of Illness; D003416:Criminal Law / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000191:economics*; D055553:Prescription Drugs / Q000191:economics*; D019966:Substance-Related Disorders / Q000191:economics*; D014481:United States; D017132:Workplace / Q000191:economics; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs